Original Investigation

Psilocybin in the Treatment of Cocaine Use Disorder

JAMA Network Open 10.1001/jamanetworkopen.2026.11029

May 07, 2026 at 11:00 AM EDT

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Does psilocybin combined with psychotherapy elicit abstinence from cocaine in people with cocaine use disorder relative to active placebo plus psychotherapy?In this randomized clinical trial of 40 adults with cocaine use disorder, a single (25 mg per 70 kg of body weight) dose of psilocybin with manualized psychotherapy resulted in a higher percentage of cocaine abstinent days, a greater likelihood of complete cocaine abstinence, and a reduced risk of cocaine lapse through 180 days after end of treatment as compared with placebo with the same manualized psychotherapy.These findings suggest psilocybin shows promise as a novel treatment for cocaine use disorder.

Corresponding Author: Peter S. Hendricks, PhD, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, 530 Beacon Pkwy W, Ste 702, Birmingham, AL 35209 (pshendricks@uabmc.edu).

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